NR 222 UNIT 8 FINAL EXAM
FUNDS 45
NUTRITION
1. The nurse evaluates which laboratory values to assess a patient’s
potential for wound healing?
A. Fluid status
B. Potassium
C. Lipids
D. Nitrogen balance
2. The nurse is caring for a patient with dysphagia and is feeding her a
pureed chicken diet when she begins to choke. What is the priority nursing
intervention?
A. Suction her mouth and throat
B. Turn her on their side
C. Put on oxygen at 2-L nasal cannula
D. Stop feeding her and place on NPO
,A. 3. patient who is receiving parenteral nutrition (PN) through a
central venous catheter (CVC) has an air embolus. What would the
nurse do first?
A. Have the patient perform a Valsalva procedure
B. Clamp the intravenous (IV) tubing to prevent more air from
entering the line
C. Have the patient take a deep breath and hold it
D. Notify the health care provider immediately
4.A patient is receiving both parenteral (PN) and enteral nutrition (EN).
When would the nurse collaborate with the health care provider and
request discontinuing parenteral nutrition?
A. When 25% of the patient’s nutritional needs are met by the
tube feedings
B. When bowel sounds return
C. When central line has been in for 10 days
D. When 75% of the patient’s nutritional needs are met
by the tube feedings
5. The nurse is inserting a small-bore nasoenteric tube before starting enteral
feedings. What is the correct order of steps to perform this procedure?
1. Place patient in high-Fowler’s position.
2. Have patient flex head toward chest.
, 3. Assess patient’s gag reflex.
4. Determine length of the tube to be inserted.
5. Obtain radiological confirmation of tube placement.
6. Check pH of gastric aspirate for verifying placement.
7. Identify patient with two identifiers.
A. 7, 1, 3, 4, 2, 5, 6
B. 1, 3, 4, 7, 2, 6, 5
C. 7, 1, 3, 2, 4, 6, 5
D. 1, 7, 3, 2, 4, 5, 6
6.A patient’s gastric residual volume was 250 mL at 0800 and 350 mL at
1200. What is the appropriate nursing action?
A. Assess bowel sounds
B. Raise the head of the bed to at least 45 degrees
C. Position the patient on his or her right side to promote stomach
emptying
D. Do not reinstall aspirate and hold the feeding until
you talk to the primary care provider
7. Thepatient’s blood glucose level is 330 mg/dL. What is the priority nursing
intervention?
A. Recheck by performing another blood glucose test.
B. Call the primary health care provider.
C. Check the medical record to see if there is a
medication order for abnormal glucose levels.
D. Monitor and recheck in 2 hours.
8. Whichstatement made by a patient of a 2-month-old infant requires further
education?
A. I’ll continue to use formula for the baby until he is a least a
year old.
B. I’ll make sure that I purchase iron-fortified formula.
, C. I’ll start feeding the baby cereal at 4 months.
D. I’m going to alternate formula with whole milk starting
next month.
9. The nurse sees the nursing assistive personnel (NAP) perform the
following intervention for a patient receiving continuous enteral feedings.
Which action would require immediate attention?
A. Fastening tube to the gown with new tape
B. Placing patient supine while giving a bath
C. Hanging a new container of enteral feeding
D. Ambulating patient with enteral feedings still infusing
10.A patient is receiving total parenteral nutrition (TPN). What is the
primary intervention the nurse should follow to prevent a central line
infection?
A. Institute isolation precautions
B. Clean the central line port through which the TPN is
infusing with alcohol
C. Change the TPN tubing every 24 hours
D. Monitor glucose levels to watch and assess for glucose
intolerance 11.The nurse is caring for a patient with pneumonia who has
severe malnutrition. The nurse recognizes that, because of the nutritional
status, the patient is at increased risk for: (Select all that apply.)
A. Heart disease.
B. Sepsis.
C. Pleural effusion.
D. Cardiac arrhythmias.
E. Diarrhea.
12. The nurse is educating the patient and his family about the parenteral
nutrition. Which aspect related to this form of nutrition would be appropriate
FUNDS 45
NUTRITION
1. The nurse evaluates which laboratory values to assess a patient’s
potential for wound healing?
A. Fluid status
B. Potassium
C. Lipids
D. Nitrogen balance
2. The nurse is caring for a patient with dysphagia and is feeding her a
pureed chicken diet when she begins to choke. What is the priority nursing
intervention?
A. Suction her mouth and throat
B. Turn her on their side
C. Put on oxygen at 2-L nasal cannula
D. Stop feeding her and place on NPO
,A. 3. patient who is receiving parenteral nutrition (PN) through a
central venous catheter (CVC) has an air embolus. What would the
nurse do first?
A. Have the patient perform a Valsalva procedure
B. Clamp the intravenous (IV) tubing to prevent more air from
entering the line
C. Have the patient take a deep breath and hold it
D. Notify the health care provider immediately
4.A patient is receiving both parenteral (PN) and enteral nutrition (EN).
When would the nurse collaborate with the health care provider and
request discontinuing parenteral nutrition?
A. When 25% of the patient’s nutritional needs are met by the
tube feedings
B. When bowel sounds return
C. When central line has been in for 10 days
D. When 75% of the patient’s nutritional needs are met
by the tube feedings
5. The nurse is inserting a small-bore nasoenteric tube before starting enteral
feedings. What is the correct order of steps to perform this procedure?
1. Place patient in high-Fowler’s position.
2. Have patient flex head toward chest.
, 3. Assess patient’s gag reflex.
4. Determine length of the tube to be inserted.
5. Obtain radiological confirmation of tube placement.
6. Check pH of gastric aspirate for verifying placement.
7. Identify patient with two identifiers.
A. 7, 1, 3, 4, 2, 5, 6
B. 1, 3, 4, 7, 2, 6, 5
C. 7, 1, 3, 2, 4, 6, 5
D. 1, 7, 3, 2, 4, 5, 6
6.A patient’s gastric residual volume was 250 mL at 0800 and 350 mL at
1200. What is the appropriate nursing action?
A. Assess bowel sounds
B. Raise the head of the bed to at least 45 degrees
C. Position the patient on his or her right side to promote stomach
emptying
D. Do not reinstall aspirate and hold the feeding until
you talk to the primary care provider
7. Thepatient’s blood glucose level is 330 mg/dL. What is the priority nursing
intervention?
A. Recheck by performing another blood glucose test.
B. Call the primary health care provider.
C. Check the medical record to see if there is a
medication order for abnormal glucose levels.
D. Monitor and recheck in 2 hours.
8. Whichstatement made by a patient of a 2-month-old infant requires further
education?
A. I’ll continue to use formula for the baby until he is a least a
year old.
B. I’ll make sure that I purchase iron-fortified formula.
, C. I’ll start feeding the baby cereal at 4 months.
D. I’m going to alternate formula with whole milk starting
next month.
9. The nurse sees the nursing assistive personnel (NAP) perform the
following intervention for a patient receiving continuous enteral feedings.
Which action would require immediate attention?
A. Fastening tube to the gown with new tape
B. Placing patient supine while giving a bath
C. Hanging a new container of enteral feeding
D. Ambulating patient with enteral feedings still infusing
10.A patient is receiving total parenteral nutrition (TPN). What is the
primary intervention the nurse should follow to prevent a central line
infection?
A. Institute isolation precautions
B. Clean the central line port through which the TPN is
infusing with alcohol
C. Change the TPN tubing every 24 hours
D. Monitor glucose levels to watch and assess for glucose
intolerance 11.The nurse is caring for a patient with pneumonia who has
severe malnutrition. The nurse recognizes that, because of the nutritional
status, the patient is at increased risk for: (Select all that apply.)
A. Heart disease.
B. Sepsis.
C. Pleural effusion.
D. Cardiac arrhythmias.
E. Diarrhea.
12. The nurse is educating the patient and his family about the parenteral
nutrition. Which aspect related to this form of nutrition would be appropriate
